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Lopes AA, Flores PC, Diaz GF, et al. Congenital heart disease and pulmonary arterial hypertension in South America (2013 Grover Conference series). Pulm Circ. 2014;4(3):370-7doi: 10.1086/676747.
Lopes, A. A., Flores, P. C., Diaz, G. F., & Mesquita, S. M. (2014). Congenital heart disease and pulmonary arterial hypertension in South America (2013 Grover Conference series). Pulmonary circulation, 4(3), 370-7. https://doi.org/10.1086/676747
Lopes, Antonio Augusto, et al. "Congenital heart disease and pulmonary arterial hypertension in South America (2013 Grover Conference series)." Pulmonary circulation vol. 4,3 (2014): 370-7. doi: https://doi.org/10.1086/676747
Lopes AA, Flores PC, Diaz GF, Mesquita SM. Congenital heart disease and pulmonary arterial hypertension in South America (2013 Grover Conference series). Pulm Circ. 2014 Sep;4(3):370-7. doi: 10.1086/676747. PMID: 25621150; PMCID: PMC4278596.
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Pulm Circ. 2014 Sep;4(3):370-7. doi: 10.1086/676747.

Congenital heart disease and pulmonary arterial hypertension in South America (2013 Grover Conference series).

Pulmonary circulation

Antonio Augusto Lopes, Patricia C Flores, Gabriel F Diaz, Sonia M F Mesquita

Affiliations

  1. Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil.
  2. Hospital Patronato Municipal San Jose Sur, Quito, Ecuador.
  3. National University, Bogota, Colombia.

PMID: 25621150 PMCID: PMC4278596 DOI: 10.1086/676747

Abstract

South America is a territory of 17,819,100 km(2), where ∼388 million people live in 13 countries. In the region, access to medical assistance (e.g., for treatment of cardiovascular disorders) is relatively easy in metropolitan areas but difficult in remote places such as the Andes and the Amazon. Altitudes up to ∼6,700 m influence the prevalence of congenital heart disease (CHD) and pulmonary arterial hypertension (PAH). In tertiary centers, CHD is now treated earlier in life but remains an important etiology of PAH. In adolescents and adults with PAH assisted at institutions devoted to treatment of cardiovascular disorders, the relative frequency of PAH-CHD (∼50%-60%) is even higher than that of idiopathic PAH. In one big tertiary center in São Paulo, Brazil, the prevalence of advanced PAH in children and adults with CHD is 1.2% and 4.2%, respectively. In young patients with cardiac septal defects (aged up to 2 years), pulmonary vascular abnormalities are a matter of concern in the decision about operability in 4.9% of cases. Access to specific PAH drugs is not uniform in South America, being unrealistic in remote places. In big cities, there are real possibilities for management of complex CHD, neonatal disorders, and even cardiac transplantation. Research activities have been implemented at clinical, translational, and basic levels. However, because of social and economic inequalities and political issues, access to best standards of medical care remains a problem in the region as a whole.

Keywords: congenital heart disease; pediatric cardiac surgery; pulmonary hypertension; survival; von Willebrand factor

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